Organization Active NPI

MD Spine Solutions LLC

Doing business as MD Labs

  • Clinical Medical Laboratory
  • Reno, NV
National Provider Identifier
1699045674
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MD SPINE SOLUTIONS LLC
Doing business as
MD Labs
Practice address
10715 Double R Blvd
#102
Reno, NV 89521-8975
Phone
(775) 391-5221
NPI assigned
Jan 6, 2012
Last updated
Mar 12, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MD SPINE SOLUTIONS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angelique Homm
Title
Operations Manager
Phone
(775) 391-5221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

10715 Double R Blvd
#102
Reno, NV 89521-8975

Mailing address

10715 Double R Blvd
#102
Reno, NV 89521-8975
Phone (775) 391-5221

Other names 1

  • MD Labs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120516000736 NV Part B Supplier - Independent Clinical Laboratory 3678736311 Practice locations: Reno, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2032647MD Spine Solutions, LLC Dba MD Labs10715 Double R Blvd, Suite 102, Reno, NV 89521AccreditationDec 5, 2027

National Provider Directory

National Provider Directory
Part of
MD Spine Solutions LLC

Locations

10715 Double R Blvd
Reno, NV 89521

10715 Double R Blvd
Ste 102
Reno, NV 89521
Phone (775) 391-5221

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1699045674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10715 DOUBLE R BLVD",
            "address_2": "#102",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218975",
            "telephone_number": "775-391-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10715 DOUBLE R BLVD",
            "address_2": "#102",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218975",
            "telephone_number": "775-391-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD SPINE SOLUTIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MD SPINE SOLUTIONS LLC",
        "enumeration_date": "2012-01-06",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "HOMM",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "775-391-5221"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MD Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.